Sex and Diabetes

Web Resource Last Updated: 05-10-2020

Sex is an important part of many people’s lives and this doesn’t change just because you have diabetes. There are however some things you may want to think about as they may have an impact on your sex life.

How you feel about sex

There are many factors that can affect how you feel about sex and your sex drive, and not all of these are related to diabetes. Depression and anxiety, low self-esteem, being tired, and some medications can all impact on how you feel about sex.

Some issues related to your diabetes such as anxiety about having a hypo or what to do with your insulin pump (if you use one) can also make you feel uncomfortable about having sex. You’re not alone and these are issues that most people with diabetes have thought about or encountered at some point. Have a look at the Diabetes UK forum to chat with others who may be having similar problems.

Sex and relationships

Diabetes can put a strain on your close relationships, from problems you may encounter sexually to looking out for signs of a hypo – there can be many things to think about. Communication plays a big part in any relationship and it’s good for you and your partner discuss any issues and try and resolve them together. If you’re not sure where to start, try getting in touch with relationship counsellors at Relate, or call the Diabetes UK helpline for further advice.

Contraception and Sexually Transmitted Infections (STIs)

Contraception such as the contraceptive pill, injection, implant or an intra-uterine device (IUD) help prevent pregnancy but do not offer protection against sexually transmitted infections (STIs). Most STIs can be prevented by using a barrier method of contraception such as a condom or a dam. For more information on contraceptive options click here.

The combined pill, which is a mix of progesterone and oestrogen, may cause some changes in your blood glucose levels but this can usually be corrected with your treatment regime. Whatever method you decide to go for, it’s a good idea to talk them through with your diabetes care team first so you can weigh up the risks and benefits. Some of the side effects of hormonal contraceptives, such as raising your blood pressure, can put you at an increased risk of developing complications associated with diabetes.

STIs are an issue that can affect everyone but having diabetes can make the effects of an infection worse. If your blood glucose levels are high, this makes you more susceptible to developing illnesses and infections such as STIs. If you have an STI, it can cause your blood glucose levels to increase significantly which puts you at risk of developing more serious problems such as diabetic ketoacidosis.

Not all STIs are easy to treat. For example, although genital herpes can be treated there is currently no cure whilst other infections such as gonorrhoea are increasingly becoming resistant to commonly used antibiotics. Therefore, it’s important to practise safer sex using a barrier method such as condoms or dams if you aren’t planning a pregnancy. This will reduce your risk of contracting or passing on an STI. Most STIs can be avoided with safe sex, while some others, such as herpes, genital warts and pubic lice, can be passed on by skin-to-skin contact meaning you must avoid any contact with affected areas if you have a breakout, or your partner has a breakout. You can find more information from the NHS by clicking here.

Type 1 Diabetes:  Blood glucose levels

You may find that your blood glucose levels can go high or low either during or after sex. It’s important to remember that sex is a form of physical activity so it may cause your blood glucose to drop. If you use insulin or drugs like gliclazide to manage your diabetes then it may put you at risk of a low blood sugar (or hypo). The chance of you having a hypo is also increased if you’ve also been drinking alcohol. If you monitor blood glucose at home, then a good practice to follow is to check your blood glucose levels before and after having sex and keep something sugary nearby just in case you do have a hypo.

Type 1 Diabetes:  Sex and insulin pumps

There are lots of questions about what to do with your insulin pump when you have sex; Does it get in the way? What if it gets pulled out? How do you explain what it is to your partner? Can it be disconnected? The truth is there are no right or wrong answers here, it’s what works best for you. Some people find it’s easier to disconnect so it won’t get in the way and you’re less likely to have a hypo. Other people keep their pump on as it means that your blood glucose levels won’t go too high, but they may drop too low. It is just a bit of a balancing act and you’ll find what works best for you. If you have any questions or concerns about having sex when you have an insulin pump then speak to your diabetes care team or have a look on the Diabetes UK online forum.

Below Jen Grieves talks about her own experiences with sex and insulin pumps.

Pregnancy

Having a baby when you have diabetes can be dangerous for both you and the baby if it’s not carefully planned. If you’re thinking about having a baby, then this is something you will need to discuss and plan with your GP or diabetes care team to make sure you have all the necessary health checks and that your blood glucose levels are well controlled before falling pregnant. If your levels are out of control, this puts you at a higher risk of a miscarriage or stillbirth or it could lead to long-term health problems for the baby. It can also accelerate some of the complications associated with diabetes such as eye or kidney damage. See planning a pregnancy when you have diabetes for more info.

Sexual problems

Most people will encounter some problems with sex throughout their life, regardless of whether they have diabetes or not.

Women

High blood glucose levels over a long period of time can cause damage to the blood vessels and nerves that supply your sexual organs including the vulva and vagina. These changes can lead to a loss of sensation in this area which means that you may find it more difficult to produce lubrication needed to help with sex. This lack of lubrication can cause vaginal dryness which can make sex uncomfortable. Vaginal dryness can often be improved by using a sexual lubricant or vaginal moisturizer, but if it causing problems speak to your GP or diabetes care team for further advice.

High blood glucose levels also make you more susceptible to developing infections such as thrush or urinary tract infections (UTIs). This happens because there is a lot of sugar in the urine, which is a perfect breeding ground for bacteria and fungus to multiply.

Common symptoms of thrush include:

  • Itchiness or pain around the vagina
  • Discharge that might be white and thick or thin and watery
  • Pain during sex
  • Stinging when you pass urine

You can reduce your risk of getting thrush by keeping your blood glucose levels under control, avoiding perfumed shower gels or wipes, wearing cotton underwear, using condoms to stop it spreading and taking showers instead of baths.

You can buy antifungal medicine from your local pharmacy to treat thrush. This can be a tablet you can swallow, a tablet you can insert into your vagina (called a pessary) or a cream to relieve the irritation.

Urinary tract infections are more common in women than men and are an infection in any part of your urinary system. Most infections involve the lower urinary tract.

Common symptoms of a urinary tract infection are:

  • A pain or a burning sensation when you pass urine
  • Needing to urinate more frequently
  • Smelly or cloudy urine
  • Pain in the lower part of your tummy

You can reduce the risk of getting a UTI by keeping your blood glucose levels under control, drinking plenty of fluids, going to the toilet regularly, wearing loose cotton underwear and taking showers instead of baths.

With a mild UTI the symptoms will normally pass within a couple of days. Make sure that you drink plenty of fluids, rest and take paracetamol as needed. For a more severe or persistent UTI you will need to see a doctor or nurse who will prescribe you a course of antibiotics.

Men

High blood glucose levels over a long period of time can cause damage to the blood vessels and nerves that supply blood to your sexual organs. This can lead to a loss of sensation which means that you may find it difficult to get aroused.

The most common occurrence for men is erectile dysfunction, which is sometimes known as impotence. This is when you are unable to get or maintain an erection and there are several reasons why this may happen. It could be down to limited blood flow, nerve damage, damaged blood vessels, certain medications or because of emotional or psychological problems. Having diabetes for a long time can increase the risk, and 50% of men with diabetes over 50 years old report problems with erections.

Erectile dysfunction can either be treated with medications such as Viagra (also known as Sildenafil) or Cialis (also known as Tadalafil), therapy or counselling. People with diabetes can develop some problems with their heart, so not all medications will be suitable for everyone. Make sure that any medications that you take have been reviewed and prescribed by your doctor.

There are other factors such as alcohol, ageing and drugs that can contribute to erectile dysfunction so it’s a common problem that happens to many men at some point in their lives.

Thrush is a fungal infection that is more common in women, but men can also get it. It causes the head of the penis or under the foreskin to become itchy or sore. You may also notice a discharge or white patches on the end of your penis. If you notice any of these symptoms, then you should speak to your doctor.

You can reduce your risk of getting thrush by keeping your blood glucose levels under control, avoiding perfumed shower gels or wipes, wearing cotton underwear, using condoms to stop it spreading and taking showers instead of baths.

Men can also develop Urinary Tract Infections, but these are also more common in women. If your blood glucose levels are high, then it means that you have more sugar in your urine which allows bacteria to multiply.

Common symptoms of a urinary tract infection are:

  • A high temperature
  • Discomfort passing urine
  • Pain in your back and sides
  • Feeling sick or vomiting
  • Feeling confused or restless

You can reduce the risk of getting a UTI by keeping your blood glucose levels under control, drinking plenty of fluids, going to the toilet regularly, wearing loose cotton underwear and taking showers instead of baths.

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